Healthcare Provider Details

I. General information

NPI: 1053105502
Provider Name (Legal Business Name): HUCKLEBERRY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8761 DORCHESTER RD STE 200
NORTH CHARLESTON SC
29420-7322
US

IV. Provider business mailing address

8761 DORCHESTER RD STE 200
NORTH CHARLESTON SC
29420-7322
US

V. Phone/Fax

Practice location:
  • Phone: 843-212-6979
  • Fax:
Mailing address:
  • Phone: 843-212-6979
  • Fax: 843-628-0342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. NARLIN SMITH
Title or Position: EXECUTIVE DIRECTOR
Credential: NP
Phone: 843-212-6979